The Cost of Healthcare

blood pressure

“Why don’t you just go to the doctor?” my husband asks after hearing my chest crack and pop.

“It’s complicated,” I moan in pain.

Maybe he doesn’t know about the extent of my white coat syndrome and that merely making an appointment makes my heart race and my palms get sweaty. Or that as a kid, I never went to the doctor outside of ingesting a battery or being covered with purple lesions.  And if we did go, it always resulted in the occurrence of something uncomfortable or more painful than the original issue.

As an adult, there is little difference except that now the pain comes from the initial cost of the copay and then later the portion of the bill not covered through insurance.

“It’s all explained in your insurance policy,” the customer service rep explains. “You know, in the really fine print. You agreed to pay for anything not covered when you signed in to see Dr. Gulash.”

Trickery and crooks! I scream in my mind, and then passively settle on a monthly payment of six months to pay off the balance.  It’s easier than taking a stand and getting sent to collections.   The bitter sting of that bill is still on my mind as I refuse to get the cracking and popping evaluated, not just yet anyway.

Let’s follow the journey of Papa Puney who decided not to wait until there were no other options and his proactive approach to his healthcare.

Papa Puney is fit man in his fifties; he sits in a hard plastic chair at the doctor’s office, off to the side and away from the sick people. There are stacks of germ covered magazines next to a pump bottle of hand sanitizer.  It’s a nice gesture but too little too late for most.

He calmly waits and peruses through emails and Facebook on his phone.   He has been working to lower his blood pressure through diet, exercise and limiting his views on the Donald’s latest tweets.   He moves his upper lip unconsciously and the mustache above it bristles out, not unlike a well groomed porcupine, as he flips through the online posts.

A young woman with dry, dyed black hair pops her head out of the door next to the receptionist’s desk.

“Mr. Papa Puney?”

She holds the door open with shiny, red nails. The man looks up in acknowledgement of his name.

“We’re ready for you now.”

Opening the door wider, she waits for the proactive patient to follow her down a tile hallway that smells of antiseptic cleaner.

The woman chews gum as she leads the man into his own room.   PP feels a seed of irritation begin to grow with each snap and pop of the gum.

“Sit right here and the nurse practitioner will be right in,” she gestured with her hand to another hard backed chair.

“Wait a minute, what about the doctor?”

“Oh, he is too busy to see you today. The NP will be right in,” the woman explains cheerfully and leaves before PP can say anything else.

PP waits and feels his heart rate increasing and the blood pulsing through his veins. PP waits and waits, keeping busy by cruising the internet until he reaches the end of the interwebs and still he waits.

Finally, the door opens and a chubby blonde woman in her early thirties with purple Crocs enters the room.

“Hey there, Bub, what’s going on with this blood pressure of yours?”

“Bub?” PP asks.

He feels a pounding in his head as his blood pressure rises like a tribal drum urging him on to stand and leave. No, this is not going to work.  There are other ways to lower blood pressure.   PP excuses himself from the clinic and takes a trip to Burger King to reassess his health goals and the price of proactivity.

Bub out.

Timely

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The April Fool

chains

Freedom doesn’t mean much until it’s gone.

Deb never knew about the danger of healthcare until she started to really use it. Her diabetes got out of control, so she started going to the ER. She became what is called a “frequent flier” and got tagged as a high cost patient. A team was quickly dispatched to figure out what was driving these frequent visits and put a fix to things before the costs rose any higher.

The team sent her for testing and to specialists for this and that, they reviewed her medications and medical records and came to a conclusion. She was a slow learner with a poor memory and should no longer work, live by herself, handle her own medications or finances.

Wow, what an amazing conclusion made by the team. She should be made an inmate in someone’s home, better yet, maybe have her arrested and taken to prison for being too much trouble, medically speaking.
The team looked around the office once they reached their conclusion for someone to give Deb the good news. Her problems were over. The team had figured everything out.

“There’s really no point in explaining the tests to her, it’s not like she’ll remember.” One team member said to the uproarious laughter of his colleagues.

“You are always good for a laugh,” one woman in scrubs said, red in the face from the funny joke.

They put their heads together in a huddle, like a team preparing to take the field, and came out of it with a plan.

They chanted, “Send in the social worker, send in the social worker, send in the social worker.”

I nodded and straightened up my shoulders, stood a little taller and prepared to take the invisible chains of future bondage into Deb. The team lined up and patted my backside as I walked past them and said encouraging things, like “Go get ‘em” and “Keep your head up.”

There was no time for stretching or to run a few plays first, I had to get to Deb before they did.

I knew what to do.

I walked into the room and closed the door. Deb sat on a chair with a massive purse overflowing with Kleenex’s and crumpled papers on the chair next to her. I stood in front of her and put my hands on her shoulders.

In my most serious voice, I whispered, “You need to leave right now and never come back. Go as far as you can and then keep going. Don’t answer any calls or sign paperwork from these people; they want to take your freedom from you. They want to take your life.”

She cocked her head to one side and looked blankly at me for a minute. Then she started laughing showing her strong white teeth. It was a big, hearty laugh that surprised the team, waiting outside, listening with a cup to the door.

“You people are always joking in here. April’s Fool’s Day, I get it. How much longer is the wait?”

I shook my head, “For you, not much longer. Your troubles are just about to be over.”

Healthcare and Honey

med

It’s made up of two basic words, health and care. The word is a prescription in itself for its function in the care of health. Yet, when sitting in on a healthcare meeting today, the only theme that I could draw was the pursuit of money. They discussed reimbursement, incentives, and the bonus structure and barely touched on patient care. By the way, this was a monthly staff meeting, not a finance review.

What happened to doing the right thing for the right reason? Naysayers might respond with something like, the insane cost of med school and malpractice insurance happened, along with the need to live in a house nice enough to keep the wife/husband/life partner and kids/cats/dogs/exotic pets happy, along with the desire to drive a reliable luxury car to keep up the image of being a doc.

Healthcare workers (I’m referring to the specific workers who have an M.D.) are placed in a position of power over the sick and injured, as is any healthy person over the unhealthy. There should be a certain social responsibility to provide the care and treatment needed to restore balance to the patient, regardless of insurance carrier or plan. At what price to the country, community, and to the physician would this cost?

Stratification, statistics, disease, demographics, containment, outcomes and cost are all variables in the healthcare mess with only one element that really matters. If you guessed anything that doesn’t rhyme with honey, than you are likely not reading this post very closely.

In truth, it all comes down to money. Can you pay or can’t you, and yes, there will be a different result based on your answer. Perhaps a return to the barter system could be part of the solution, service for goods, like farm fresh eggs or an old cell phone for an exam. Surgery would cost a bit more, like an agreement to mow the surgeon’s lawn for a year or the gift of the patient’s first born son.

It certainly would be easier if we still needed each other to live instead of just for the accumulation of dollars and cents.

Often, I find myself wondering about the true cost of this value proposition on our souls and on the future.

And all for what?

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